Carotid-femoral pulse wave velocity (cfPWV) is the current gold standard to assess arterial stiffness, a strong predictor of cardiovascular mortality. Recently, some studies demonstrated that cfPWV was independently correlated with LDL cholesterol.

The aim of this study was to assess the correlation of apolipoprotein B and cfPWV.

During a complete work-up of hypertension, lipids parameters were collected after an overnight fast. CfPWV was measured with a Complior device. Real travel distance was used (0.8×direct travel distance) to assess PWV as recommended.

Our cohort included 973 hypertensive patients with the following characteristics: age 50.5±14.8 years, 51.1% of men, blood pressure 150±25/84±15mm Hg, body mass index 26.8±4.8kg/m², 20.1% of smokers, 14.2% of diabetes, eGFR 87.0±23.1mL/min, total cholesterol 5.1±1.0mmol/L, LDL cholesterol 3.1±0.9mmol/L, non-HDL cholesterol 2.0±0.5mmol/L, apolipoprotein B 1.0±0.3mmol/L and cfPWV 8.8±2.4m/s. Using a continuous variable cfPWV was correlated with total cholesterol (r=0.111, P=0.001), LDL cholesterol (r=0.074, P=0.021), non-HDL cholesterol (r=0.102, P=0.002) and more significantly with apolipoprotein B (r=0.154, P<0.001). In multivariate logistic regression model after adjustment for age, sex, HR, mean BP, fasting glucose, smoking, BMI and lipid lowering therapy, a cfPWV>10m/s was independently associated with apolipoprotein B [Hazard ratio 1.91, 95% CI (1.06–3.45)] but not with total cholesterol [Hazard ratio 1.14, 95% CI (0.99–1.32)]; LDL cholesterol [Hazard ratio 1.14, 95% CI (0.96–1.34)] and non-HDL cholesterol [Hazard ratio 1.24, 95% CI (0.90–1.71)].

In this cohort of hypertensive patients, apolipoprotein B was the strongest lipid parameters associated with cfPWV. It may explain the additive prognostic value of apolipoprotein B on top of other lipid parameters to predict cardiovascular events.